Suzuki Hiroshi, Araki Koji, Matsui Toshiyasu, Tomifuji Masayuki, Yamashita Taku, Kobayashi Yasushi, Shiotani Akihiro
Department of Otolaryngology-Head and Neck Surgery, National Defense Medical College, Tokorozawa, Saitama, Japan.
Department of Anatomy and Neurobiology, National Defense Medical College, Tokorozawa, Saitama, Japan.
Laryngoscope. 2016 Jul;126(7):E233-9. doi: 10.1002/lary.25750. Epub 2015 Nov 3.
OBJECTIVES/HYPOTHESIS: Nerbridge (Toyobo Co., Ltd., Osaka, Japan) is a novel polyglycolic acid (PGA) tube that is filled with collagen fibers and that facilitates nerve fiber expansion and blood vessel growth. It is biocompatible and commercially available, with governmental approval for practical use in Japan. We hypothesized that the PGA-collagen tube would promote regeneration of the recurrent laryngeal nerve (RLN). This hypothesis was examined in a rat axotomy model of the RLN.
Prospective animal study.
The axotomy model was established by transection of the left RLN in adult Sprague-Dawley rats. The cut ends of the nerve were bridged using Nerbridge (Toyobo Co., Ltd.) with a 1-mm gap (tube-treatment group) or direct sutures (sutured-control group). Left vocal fold mobility, nerve conduction velocity, morphology, and histology were assessed after 15 weeks.
Fifteen weeks after treatment, nerve fiber connections were observed macroscopically in both groups, and more clear myelinated fibers and better prevention of laryngeal muscle atrophy were observed in the tube-treatment group compared with the sutured-control group. However, vocal fold movement recovery was not observed in either group, and the conduction velocity of the RLN did not differ between the two groups.
Better nerve regeneration was observed in the tube-treatment group. The combination therapy with molecular or gene therapy might be an effective strategy to improve vocal fold movement. The PGA-collagen tube has the potential to promote regeneration of the RLN and to be a scaffold for drug administration in these combination therapies.
N/A. Laryngoscope, 126:E233-E239, 2016.
目的/假设：Nerbridge（日本大阪东洋纺株式会社）是一种新型聚乙醇酸（PGA）管，内部填充胶原纤维，可促进神经纤维生长和血管生成。它具有生物相容性且已上市销售，并获得日本政府批准可实际应用。我们假设PGA-胶原管能促进喉返神经（RLN）再生。该假设在大鼠RLN切断模型中进行了检验。
前瞻性动物研究。
在成年Sprague-Dawley大鼠中通过横断左侧RLN建立切断模型。神经断端使用Nerbridge（东洋纺株式会社）连接，间隙为1毫米（管治疗组）或直接缝合（缝合对照组）。15周后评估左侧声带活动度、神经传导速度、形态和组织学。
治疗15周后，两组在宏观上均观察到神经纤维连接，与缝合对照组相比，管治疗组观察到更清晰的有髓纤维以及对喉肌萎缩更好的预防效果。然而，两组均未观察到声带运动恢复，且两组之间RLN的传导速度无差异。
管治疗组观察到更好的神经再生。分子或基因治疗的联合疗法可能是改善声带运动的有效策略。PGA-胶原管有促进RLN再生的潜力，并可作为这些联合疗法中药物给药的支架。
无。《喉镜》，2016年，第126卷，E233 - E239页
